The purpose of this Health Advisory is to alert the public to new information about the recent and potentially ongoing outbreak of Campylobacter infections associated with consuming raw milk distributed by a Kenai-based cow-share program.

The Alaska Section of Epidemiology (SOE) released an initial notice of this outbreak on February 15, which is available at https://www.epi.alaska.gov/phan/AKPHAN_20130215_CampyOutbreakRawMilk.pdf

How many illnesses?

To date, a total of 18 individuals have been identified in this outbreak. Some of these individuals have had recurrent illness. Two required hospitalization. SOE is planning to contact individuals suspected of receiving or consuming raw milk from the involved farm, and it is expected that the number of probable and confirmed cases will rise.

What is the source of this outbreak?

All probable and confirmed cases have been linked to consumption of raw milk from a farm on the Kenai Peninsula that operates a cow-share program. The milk is distributed to shareholders throughout the Kenai Peninsula, in Anchorage, and in Sitka. There is at least one secondary case of an infant who became ill after having close contact with a laboratory-confirmed case.

What is Campylobacter infection?

Campylobacter bacteria can cause diarrhea, abdominal cramps/pain, nausea, vomiting, and fever 1 to 10 days after exposure (usually 2-5 days). The illness typically lasts from several days to over a week, with variable severity. Some individuals, especially young children or those with compromised immune systems, can develop severe or even life-threatening illness. Campylobacter infection can lead to long-term consequences. Some individuals with Campylobacter infection develop arthritis (at least one case of reactive arthritis has occurred during the current outbreak), and rarely, some develop a life-threatening disease called Guillain-Barré syndrome that inflames the nerves of the body beginning several weeks after the onset of diarrhea.

What can you do?

Persons currently experiencing symptoms as described above should contact a health care provider and alert them to this Advisory.

Health care providers seeing patients with acute gastroenteritis should ask about raw milk exposure and obtain stool cultures. Providers should also be aware of reactive arthritis or Guillain-Barré syndrome as potential complications of Campylobacter infection.

Suspected cases should be reported to the Section of Epidemiology.

Persons who consumed raw milk in 2013 and subsequently developed a diarrheal illness should contact the Section of Epidemiology to report the illness. Please call SOE at 907-269-8000 (in Anchorage) or toll free at 1-800-478-0084 and ask to speak to a member of the Infectious Disease Team.

Please share this Advisory with anyone you know who consumes raw milk. ALL farmers, distributors, or coordinators of a cow share program should share this information with any potential consumers of raw milk.

Additional resources

• Centers for Disease Control and Prevention Campylobacter information: https://www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter/
• General raw milk information: https://www.realrawmilkfacts.com/
• Alaska 2011 Epidemiology Bulletins on a raw milk-associated Campylobacter outbreak:
• https://www.epi.alaska.gov/bulletins/docs/b2011_18.pdf
• https://www.epi.alaska.gov/bulletins/docs/b2011_22.pdf
• Alaska 2009 Epidemiology Bulletin on raw milk: https://www.epi.alaska.gov/bulletins/docs/b2009_29.pdf
• Alaska Division of Environmental Health information on raw milk: https://www.dec.state.ak.us/eh/docs/vet/Dairy/RawMilkSharesFactsheet.PDF